FPH supports findings of Hospitals on the Edge report

The Faculty of Public Health supports many of the conclusions and recommendations of the Royal College of Physicians (RCP)’s report, Hospitals on the Edge. We recognise that there are considerable pressures on acute services and very much share the RCP’s concerns about the current state of hospitals. The provision of hospital care is a whole system problem that needs to fully address problems of social care and primary care to better meet people’s needs, particularly those of older patients.

The report demonstrates how all those working in health and social care – who are hugely committed and dedicated to their work - are part of a system that is not sustainable. There are too many unnecessary admissions, overlong stays and readmissions, particularly for older people. We can also do much more to support and care for people in the community to prevent hospital admissions.

Public health professionals can contribute their expertise in needs assessment, strategic planning and evaluation of health services, partnership and whole systems working. Public health work to prevent illness and protecting the public’s health can prevent problems later on, and reduce the need for, and therefore pressure on, hospital beds.

The new commissioning environment may present some new opportunities to get things right but the risks of further fragmentation are high because of the likelihood of inexperience in new Care Commissioning Groups (CCGs). FPH is concerned that public health input into service design and needs assessment for acute care is being diluted and weakened as the Health and Social Care Act is implemented.

CCGs will need the expertise of public health professionals, which is why it is essential to have enough public health people with the right skills in the right places. In other words, we must ensure that public health expertise remains at the heart of service planning and delivery, and not forget how prevention is far better than cure.